How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $630.96 Median $2,511.89 Typical High $7,585.78 | Facility | None | $630.96 | $2,511.89 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $190.55 | Professional | None | $120.23 | $151.36 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $549.54 Median $912.01 Typical High $1,412.54 | Facility | None | $549.54 | $912.01 | $1,412.54 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $251.19 | Professional | None | $120.23 | $181.97 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $125.89 | Facility | None | $50.12 | $75.86 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $213.80 | Professional | None | $131.83 | $190.55 | $213.80 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $257.04 Typical High $1,174.90 | Facility | None | $91.20 | $257.04 | $1,174.90 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $912.01 Typical High $1,445.44 | Professional | None | $169.82 | $912.01 | $1,445.44 |
United Setting Facility Modifier None Typical Low $89.13 Median $575.44 Typical High $1,380.38 | Facility | None | $89.13 | $575.44 | $1,380.38 |
United Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $234.42 | Professional | None | $109.65 | $162.18 | $234.42 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $61.66 Typical High $95.50 | Professional | 52 · Reduced service | $60.26 | $61.66 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $24.55 Typical High $38.90 | Professional | 53 · Discontinued | $23.99 | $24.55 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $144.54 | Professional | 54 · Surgery only | $91.20 | $91.20 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $28.84 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.30 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.02 | $12.30 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $85.11 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $85.11 | $85.11 | $134.90 |
Where Oklahoma sits
The same service costs 3.3 times more in Alaska than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oklahoma· 16th of 51
$214
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.